143 articles - From Friday Dec 23 2022 to Friday Dec 30 2022
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Clin Gastroenterol Hepatol |
| Gastrointest Endosc |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
Meta-analysis: Efficacy and safety of albumin in the prevention and treatment of complications in patients with cirrhosis. Albumin may reduce mortality risk in cirrhotic patients with SBP or HE. No benefit was identified in reducing liver transplants or SAEs. Long-term administration may be associated with a lower risk of cirrhosis complications and need for paracentesis. |
| Am J Gastroenterol |
Comparative Performance of Endoscopic Ultrasound-based Techniques in Patients with Pancreatic Cystic Lesions: A Network Meta-analysis. For centers with relevant expertise and facilities, EUS-TTNB and EUS-nCLE were better choices for the diagnosis of PCLs. Further studies are urgently required for further improving PCF biomarkers and validating diagnostic performance of the index techniques. |
| Endosc Int Open |
| Gut |
Production and possible reduction of greenhouse gases produced during GI endoscopy activity: a systematic review of available literature. Recognition of carbon emissions generated by GI endoscopy activity is critical. Although multiple limitations exists for quantification of these emission, there is an urgent need for collecting proper data as well as examining novel methods for reduction of these emissions for a sustainable endoscopic practices in the future. |
| J Hepatol |
Hepatocellular carcinoma risk in patients with chronic hepatitis B receiving tenofovir-vs. entecavir-based regimens: individual patient data meta-analysis. TDF was associated with significantly lower HCC risk than ETV in CHB patients, particularly those with HBeAg positivity. Longer follow-up may be needed to better define incidence differences between the treatments in various subgroups. Impact and implications Previous aggregate data meta-analyses have reported inconsistent conclusions on the relative effectiveness of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in reducing hepatocellular carcinoma (HCC) risk in patients with chronic hepatitis B (CHB). This individual patient data meta-analysis on 11 studies involving 42,939 patients from Korea, Taiwan, and Hong Kong suggested that TDF-treated patients have a significantly lower HCC risk than ETV-treated patients, which was observed in al subgroups of clinical interest and by different analytical methodologies. These findings may have to be taken into account by healthcare providers when determining the optimal course of treatment for patients with CHB and may be considered in ensuring that treatment guidelines for CHB remain pertinent. |
| Neurogastroenterol Motil |
Dysphagia treatments in Parkinson's disease: A systematic review and meta-analysis. However, given the limited number of small RCTs for each type of treatment, the evidence remains weak and uncertain. Further large-scale, multicenter RCTs are warranted to fully explore their clinical efficacy in the PD population. |
Factors influencing rectal hypersensitivity in irritable bowel syndrome: A systematic review and meta-analysis. The results suggest that reduced rectal pain threshold to experimental stimulation is far more common in IBS patients than healthy controls. Further research is required to understand the pathophysiological and therapeutic implications of rectal sensitivity such as its role in measuring response to treatment and prognosis in IBS. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Effectiveness and safety of risankizumab induction therapy for 100 patients with Crohn's disease: A GETAID multicentre cohort study. In a cohort of highly refractory patients with luminal CD and multiple prior drug failures including ustekinumab, risankizumab induction provided a clinical response in about 3 out of 4 patients and steroid-free clinical remission in about half of patients. |
Factors associated with lower disease-specific and generic health-related quality of life in Rome IV irritable bowel syndrome. Avoidance of alcohol, lower educational level, abnormal anxiety, depression or somatoform symptom-reporting scores, and impairment in social leisure activities, home management or maintaining close relationships were al independently associated with lower quality of life. IBS has a substantial impact on the quality of life of those affected, and worse than observed in some severe chronic organic conditions. |
Improved prediction of 10-year risk of severe liver disease in the general population using commonly available biomarkers. Identification of subjects at increased risk of severe liver disease in the general population using the FIB-4 score can be substantially improved by adding age and specific biomarkers commonly available in the primary care setting. These parameters should be considered for inclusion in the development of future risk prediction models. |
Potential benefit and lack of serious risk from corticosteroids in drug-induced liver injury: An international, multicentre, propensity score-matched analysis. Corticosteroid therapy did not worsen outcome in DILI patients. Indeed, corticosteroid administration was associated with a greater rate of normalisation of liver enzymes in patients with serious DILI. |
Stromal vascular fraction with platelet-rich plasma injection during surgery is feasible and safe in treatment-refractory perianal fistulising Crohn's disease: A pilot study. Injection with autologous SVF with PRP is feasible and safe in patients with treatment-refractory pCD. Early complete radiological healing was observed in more than one-third of patients, and clinical response in two-thirds of patients at 12 |
| Am J Gastroenterol |
Consumption of two green kiwifruit daily improves constipation and abdominal comfort - results of an international multicentre randomised controlled trial. This study provides original evidence that the consumption of a fresh, whole fruit has demonstrated clinically relevant increases in CSBM and improved measures of GI comfort constipated populations. Green kiwifruit are a suitable dietary treatment for relief of constipation and associated GI comfort. |
Diagnosing Mild Forms of Anorectal Malformation With Anorectal Manometry: A Prospective Study. We consider 3D-HRAM a reliable tool for diagnosing and excluding rectoperineal CARM. Using this method in patients suspected of CARM might keep infants from undergoing unnecessary interventions requiring anesthetics, such as ES. By providing objective insight into the functional capabilities of the anal sphincter, anorectal manometry adds to the diagnosis. |
Examining the Nocebo Effect in Trials of Neuromodulators for Use in Disorders of Gut-Brain Interaction. Patients with DGBIs in RCTs randomized to placebo groups frequently experience AEs and AEs that lead to withdrawal consistent with a strong nocebo effect. Non-specific AEs such as dizziness, headaches and diarrhea occurred similarly in patients receiving placebo compared to those receiving neuromodulators. |
Fecal microbiota transplantation across the lifespan: balancing efficacy, safety, and innovation. There are unique concerns regarding FMT as it pertains to children, adults, and the elderly. In this review, we seek to update clinicians, researchers, and regulators on how these factors must be balanced across the lifespan as we move forward with this innovative therapy. |
Patency capsule: A novel independent predictor for long-term outcomes among patients with quiescent Crohn's disease. Clinically-stable CD patients with failed-PC have worse long-term clinical outcomes than those without, independently of CD phenotype. Standalone PC may serve as a novel, safe and affordable prognostic examination, to identify patients with quiescent CD who have a higher risk for future worse clinical outcomes. |
REMIT-UC: Real World Effectiveness and Safety of Tofacitinib for Moderate-to-Severely Active Ulcerative Colitis. One-third of UC patients treated with tofacitinib achieved clinical remission with few serious adverse events. However, half of patients lost response with de-escalation, which was only partially recaptured with increasing the maintenance dose. Those with negative prognostic factors should be counselled about the risks and benefits of continuing high dose tofacitinib. |
Transpapillary Stenting Improves Treatment Outcomes in Patients Undergoing Endoscopic Transmural Drainage of Ductal Disruption-Associated Pancreatic Fluid Collections. Transpapillary pancreatic duct stenting seems to improve the efficacy of endoscopic TMD of pancreatic duct disruption-associated PFCs by reducing the recurrence rate and shortening the length of hospital stay. |
| Clin Gastroenterol Hepatol |
Associations of Antibiotics, Hormonal Therapies, Oral Contraceptives, and Long-Term NSAIDs with Inflammatory Bowel Disease: Results from the Prospective Urban Rural Epidemiology (PURE) Study. Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates. |
Monitoring patients with eosinophilic esophagitis in routine clinical practice - International Expert Recommendations. It was concluded that effective maintenance treatment probably reduces the development of EoE complications, and regular, structured and under certain conditions individualized clinical follow-up is recommended to assess disease activity while opening a window to monitoring side-effects, adjusting therapy and encouraging adherence to treatment. Follow-up should comprise symptom assessment and periodic or repeated endoscopy with histological assessment in specific EoE settings. |
Non-invasive assessment of postoperative disease recurrence in Crohn's Disease: a multicenter, prospective cohort study on behalf of the IG-IBD. A non-invasive approach combining bowel US and FC can be used with confidence for detecting POR in patients with CD without the requirement for CS. |
Quality of surveillance impacts the colitis-associated advanced neoplasia risk: a multicenter case-control study. Surveillance compliant with primary quality indicators is associated with a reduced colitis-associated AN risk. Delayed surveillance intervals and active inflammation were associated with an increased AN risk. This underlines the importance of procedural quality, including endoscopic remission to optimize the effectiveness of endoscopic surveillance. |
| Endosc Int Open |
A new system to prevent SARS-CoV-2 and microorganism air transmission through the air circulation system of endoscopes. ENDOBOX SC prevents the increase in temperature induced by lamps and processors, allows access to al necessary connections into the endoscopic columns, and creates a sterile and positive pressure volume, which prevents potential contamination from microorganisms. |
Early phase trial of intracystic injection of large surface area microparticle paclitaxel for treatment of mucinous pancreatic cysts. Intracystic injection of LSAM-PTX into mucinous PCLs resulted in no significant AEs, a lack of systemic absorption, and resulted in reduction of cyst volume over a 6 month period. |
Endoscopy training in the Netherlands: a national survey among gastroenterology residents. Although most gastroenterology residents were satisfied with the endoscopy training program and endoscopy supervision in their teaching hospital, this study identified considerable local and regional variability. Future studies should be conducted to evaluate the trainers' perspective and trainers' behavior during endoscopy training sessions, which might eventually lead to the development of best practices regarding endoscopy training, including standardization of training programs and supervision methods. |
Frequency and nature of endoscopic and pathologic errors leading to referral for endoscopic resection to a tertiary center. Endoscopists at tertiary centers should expect referrals to clarify the nature of colorectal lesions as neoplastic or non-neoplastic. Community endoscopists with equivocal endoscopic findings and unexpected or equivocal pathology results can consider pathology review at their center or at an expert center before referral for endoscopic or surgical resection. |
Implementation of the Aldrete score reduces recovery time after non-anesthesiologist-administered procedural sedation in gastrointestinal endoscopy. Implementation of the Aldrete score after procedural sedation and analgesia significantly reduces the time spent in the recovery area. The score can be used to safely implement a discharge policy that provides more efficient and standardized management for an endoscopy service. |
Quality of life in patients with achalasia: Associations with Eckardt score and objective treatment outcomes after peroral endoscopic myotomy. Following POEM, a significant and clinically relevant QoL improvement is observed. QoL is associated with ES, but not with objective results after POEM. |
| Gastroenterology |
Development and validation of the TUMMY-UC, a Patient Reported Outcome for Pediatric Ulcerative Colitis. The |
Integrated multi-omics Landscape of liver metastases. Furthermore, SLC2A1 promoted immune escape and liver metastasis through inducing regulatory T cells including Tregs and LAG3+CD4+ T cells in primary colorectal cancer. The study provided integrated multi-omics landscape of liver metastasis, uncovering potential mechanisms for vicious IM subtypes and confirming the roles of SLC2A1 in regulating tumor microenvironment remodeling in both primary tumor and liver metastatic lesions. |
Negative Impact of Disorders of Gut-Brain Interaction on Health-related Quality of Life: Results from the Rome Foundation Global Epidemiology Survey. This study is the most comprehensive assessment of quality of life to date in adults living with a DGBI. It provides a representative picture of DGBI impact on adults in the global adult population, and highlights the significant detrimental impact of living with a DGBI on quality of life. |
| Gastrointest Endosc |
A novel ultra-low volume regimen combining 1 L polyethylene glycol and linaclotide versus 2 L polyethylene glycol for colonoscopy cleansing in Low-Risk individuals: A Randomized Controlled Trial. 1L PEG+L regimen was not inferior to 2L PEG on colon cleansing with better tolerability and higher willingness to repeat in low-risk population. |
Endoscopic closure of refractory upper gastrointestinal-tracheobronchial fistulas with a novel occluder: a prospective, single-arm, single-center study. Our clinical outcomes suggest that this novel gastrointestinal occluder is a safe and effective salvage option for patients with refractory upper gastrointestinal-tracheobronchial fistulas. |
EUS-guided enterocolostomy with lumen-apposing metal stent for palliation of malignant small-bowel obstruction (with video). EUS-EC is a new alternative for palliation of acute SBO due to advanced malignant disease when conservative measures fail and other surgical or endoscopic options are not possible. Additional larger studies with longer duration of follow-up are needed to further define efficacy and safety of this approach. |
Small-bowel capsule endoscopy in patients with Meckel`s diverticulum: clinical features, diagnostic workup, and findings. A European multicenter I-CARE study. Diagnosis of MD is rare and sometimes challenging and a preoperative gold standard does not exist. In SBCE the most frequent findings were double-lumen sign and visible diverticular entrance, sometimes together with ulcers. |
Underwater vs. Conventional EMR of Large Nonpedunculated Colorectal Lesions: A Multicenter Randomized Controlled Trial. UEMR is a valid alternative to CEMR of LNPCL and could be considered the first option of treatment for lesions between 20-30 mm due to its higher en bloc and R0 resection rates. |
| Gut |
Cardiovascular disease risk in paediatric and young adult non-alcoholic fatty liver disease. Compared with matched population controls, children and young adults with biopsy-proven NAFLD had significantly higher rates of incident MACE, including ischaemic heart disease and congestive heart failure. Research to better characterise cardiovascular risk in children and young adults with NAFLD should be prioritised. |
| J Hepatol |
Acute severe non-A-E-hepatitis of unknown origin in children - a 30-year retrospective observational study from north-west Germany. Acute non-A-E-hepatitis in children is a rare but severe entity, often leading to acute liver failure. Clinical presentation in our current cohort resembles 2022 NAEH cases, and outcome has improved compared to historic controls. The rising incidence in our centres since 2019 without adenoviral infection, shortly before and during SARS-CoV-2-pandemia, indicates other potential triggers than Adenovirus for comparable NAEH cases. Impact and implications As the current epidemic of severe acute non-A-E-hepatitis cases in children highlights our limited understanding in the field, we aim to improve clinicians´ comprehension and ultimately their clinical management of this disease by the description of current cases, characterisation of the presentation over time, and definition of similarities and discrepancies, before and during the COVID-19 pandemic. Our data show a rising incidence of comparable non-A-E-hepatitis cases since the beginning of the COVID-19 pandemic, without association to adenoviral infections, possibly suggesting the recently described accumulation of Adenovirus infections in relationship to hepatitis as a new trigger for a known phenomenon, rather than a new disease entity. Therefore, the role of protective isolation and subsequent lack of contact to trivial infections in children during the pandemic should be the subject of further examinations. We expect our data to contribute to a better understanding of severe acute hepatitis in childhood, an increased vigilance for this potentially lethal disease beyond the current epidemic, and ultimately improved clinical diagnosis and care. |
Charting co-mutation patterns associated with actionable drivers in intrahepatic cholangiocarcinoma. A detailed knowledge of the most prevalent genomic constellations is fundamental to accelerate therapeutic developments in iCCA. Our study provides a valuable resource for feasibility assessment of clinical trials and subgroup analyses, spurs the development of translationally relevant preclinical models, and generates a knowledge ground to anticipate potential resistance mechanisms to targeted therapies in genomically defined subgroups of iCCA patients. Impact and implications Due to the high frequency of targetable alterations, molecular diagnostics is recommended in patients with biliary tract cancers, and especially in those with intrahepatic cholangiocarcinoma. The identification of an actionable lesion, however, does not guarantee for therapeutic success, and the co-mutational spectrum may act as a critical modifier of drug response. Using a large dataset of comprehensive panel sequencing results from 6130 intrahepatic cholangiocarcinoma patients, we provide a detailed analysis of the co-mutational spectrum of the most frequent druggable genetic alterations, that is meant to serve as a reference to establish genetically relevant preclinical models, develop hypothesis driven combination therapies and identify recurrent genetic profiles. |
Defining the serum proteomic signature of hepatic steatosis, inflammation, ballooning and fibrosis in nonalcoholic fatty liver disease. Serum protein scanning identified signatures corresponding to the key components of liver biopsy in NAFLD. The models developed were sufficiently sensitive to characterize the longitudinal change for three different drug interventions. These data support continued validation of these proteomic models to enable a "liquid biopsy"-based assessment of NAFLD. |
Targeting proteostasis of the HEV replicase to combat infection in preclinical models. Moreover, these anti-HEV drugs were validated in an HEV rodent model and found to be safe and efficient for prevention of HEV-induced liver injury in preclinical experiments. Our findings substantially promote the understanding of HEV pathobiology and the pace of antiviral development. |
| J Neurogastroenterol Motil |
Usefulness of EndoFLIP in diverticular peroral endoscopic myotomy for symptomatic epiphrenic diverticulum. EndoFLIP may help decide whether to perform combined cardiomyotomy and septotomy for the treatment of an epiphrenic diverticulum. Further large-scale studies are needed to confirm these results. |
| Neurogastroenterol Motil |
Chronic opioid users with dysphagia are indistinguishable from symptomatic nonusers on functional lumen imaging probe evaluation. Symptomatic chronic opioid users have FLIP diagnoses that are similar to nonusers, despite higher perceptive symptoms and worse quality of life. Dominant symptoms improve both in chronic opioid users and nonusers following treatment directed by FLIP. |
Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders. Functional gastrointestinal disorders comorbidity is highly prevalent in chronic constipation and defecatory disorders, and this is associated with greater symptom severity and worse QoL. Multimodal treatments targeting comorbid FGIDs may lead to superior outcomes. |
Maximum lingual pressure impacts both swallowing safety and efficiency in individuals with amyotrophic lateral sclerosis. Reduced lingual strength was confirmed in this group of 97 individuals with ALS that was associated with a diminished ability to effectively transport boluses and aide in laryngeal vestibule closure to prevent entry of material into the airway. |
Somatization is associated with altered serum levels of vitamin D, serotonin, and brain-derived neurotrophic factor in patients with predominant diarrhea irritable bowel syndrome. These data support the multifactorial IBS pathogenesis in which organic and psychological factors interact. An active role by VD, 5-HT, and BDNF in affecting the clinical and biochemical profiles in IBS-D(S+) patients may be conceivable. Therefore, the routine VD estimation and the assay of circulating levels of 5-HT and BDNF could be considered a new approach for managing these patients. |
The influence of supragastric belching severity on esophageal acid exposure and motility. Supragastric belching is common, associated with higher incidence of IEM and is responsible for almost a third of esophageal acid burden. The impact of SGB is proportional to its severity. Diagnosis of SGB should be sought in patients with excessive belching and in patients with refractory reflux symptoms. Recognizing SGB and treating patients with behavioral therapy may alleviate acid exposure and improve quality of life. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: diagnosis, pathophysiology and management of atrial fibrillation in cirrhosis and portal hypertension. Atrial fibrillation is increased in patients with cirrhosis. AF management requires careful consideration of treatment options. Since patients with cirrhosis were excluded from al major randomised clinical trials, dedicated research on the pathophysiology and management of AF in cirrhosis is needed. |
| Clin Gastroenterol Hepatol |
Emerging Tests for Non-Invasive Colorectal Cancer Screening. These emerging tests include blood-based assays that use plasma-derived circulating tumor DNA and serum proteins to detect early CRC and advanced adenomas, assays that use stool DNA or mRNA, and methods for profiling the gut microbiome. Here we review current screening modalities, and we discuss the principles behind the most promising emerging CRC screening tests and the data supporting their potential to be used in clinical practice . |
RISK FACTORS FOR METACHRONOUS COLORECTAL CANCER OR ADVANCED ADENOMAS AFTER ENDOSCOPIC RESECTION OF HIGH-RISK ADENOMAS. Metachronous CRC risk is highest in patients with baseline adenomas with =20mm or HGD. Multiplicity does not seem to be associated with substantially higher CRC risk. |
Tools to Measure the Impact of Structural Racism and Discrimination on Gastrointestinal and Hepatology Disease Outcomes: A Scoping Review. While upstream intervention studies primarily focused on policies related to colon cancer screening and organ graft allocation, racial and ethnic disparities often persisted post-intervention. To achieve health equity in GI and liver conditions, there is an urgent need for research that goes beyond describing health disparities to incorporating measures of SRD and implementing interventions that address this understudied determinant of health. |
| Endosc Int Open |
| Endoscopy |
| Gastrointest Endosc |
| J Hepatol |
Beta-blockers in the era of precision medicine in patients with cirrhosis. The clinical risk-to-benefit ratio appears to deteriorate in advanced decompensated stages and the risk of harm is high in patients with refractory ascites, low blood pressure and renal impairment, which clinically define closure of the therapeutic window. We also critically review non-invasive surrogates and biomarkers for predicting the haemodynamic response to NSBBs and confirm that the absence of reliable non-invasive methods is one of the main challenges facing the field. |
NAFLD and NASH Biomarker Qualification in the LITMUS consortium - Lessons learned. Sharing knowledge of such interactions with the scientific community is of paramount importance to increase the chances of qualification of relevant biomarkers that may accelerate drug development, and thereby help patients, across disease indications. A qualified biomarker enables a decision to be made that al understand and support in a common framework. |
| Neurogastroenterol Motil |
Electrical devices for functional visceral pain. In addition to motor effects, there were also significant effects on GERD symptoms, raising the question whether extrinsic electrical nerve stimulation of the gut can reduce symptoms through effects that target sensation. This brief review summarizes evidence regarding the application of electrical acustimulation, transauricular electrical stimulation, and sacral electrical or magnetic stimulation to reduce abdominal or pelvic pain. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endosc Int Open |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| J Hepatol |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| J Hepatol |
| Neurogastroenterol Motil |